UNC study: Fasting may not be needed for children’s cholesterol tests

Physicians usually ask children to fast overnight before a cholesterol test. New research from the University of North Carolina at Chapel Hill School of Medicine shows that this may not always be necessary.

“Cholesterol testing can be very difficult for families,” said Asheley Cockrell Skinner, PhD, lead author of the study, presented Sunday, May 2 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada. “When having to fast, this almost always means the child has to return on another morning for the test, which can be very problematic for busy families.”

Studies in adults have shown that some parts of cholesterol testing can be performed without fasting. To see if the same holds true for youngsters, Skinner and her UNC colleagues, Eliana Perrin, MD, MPH, and Michael Steiner, MD, studied a nationally representative sample of about 17,000 children and adolescents.

They used data from the National Health and Nutrition Examination Survey (1999-2006), which include results of cholesterol testing on children ages 3 and older and whether they had fasted for eight hours or more. Researchers looked at whether total cholesterol (TC), high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides were related to whether the child had fasted.

Results showed that those who fasted for at least eight hours and those who did not fast had similar levels of TC and HDL (good) cholesterol, and that LDL (bad) cholesterol was only slightly higher when fasting. Triglycerides did vary depending on whether the child had fasted.

“These results suggest it might be acceptable to simply test children immediately during whatever clinical visit prompted the recommendation to test,” Skinner said. “Because the American Academy of Pediatrics recommends cholesterol screening for a large group of children, these findings could reduce the burden of such screening.”